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This paper investigates the impact of physical infrastructure development on economic growth in MENA region. It adopts generalized method of moments with system estimators to estimate an endogenous growth model during 2000-2016 for a sample of 30 developing or emerging countries including nine MENA countries. It utilizes the generalized method of moments (GMM) to account for heterogeneity and endogeneity in the specified model. This growth model is augmented with a synthetic infrastructure quantity index developed using the principal components analysis (PCA) for two infrastructure sectors, which are telecommunications and energy. The results reveal that infrastructure quantity has contributed positively to economic growth for the whole sample of countries as well as MENA countries, and the specification tests validates the specified model.

This paper examines the macroeconomic determinants of external debt in Egypt during 1977-2020 using Johansen cointegration test and a vector error correction model (VECM). It tries to fill the research gap due to the lack of empirical studies on the determinants of external debt accumulation in Egypt. The results of Johansen cointegration show that there is a long-run equilibrium relationship between the model variables. Furthermore, the long-run cointegrating equation reveals that there is a negative relationship between gross domestic savings and external debt accumulation in Egypt, whereas government final consumption expenditure, trade openness, and total external debt service are positively related to external debt accumulation in Egypt. Accordingly, some policy recommendations can be suggested to deal with the growth of Egypt's external debt such as boosting gross domestic savings rate through achieving higher growth rates, increasing government revenues through widening the tax base, directing the funds acquired from external borrowing to highly-productive projects that generate high rates of return in excess of interest payments on external debt, and implementing an industrialization program that is complemented with an export promotion strategy that aims at increasing exports and hence, reducing the foreign exchange gap.

This study aims to analyse the impact of workers' remittances on the non-governmental foreign currency deposits on quarterly bases during the period from 2006 to 2019 using the ARDL approach. The study's main findings are that workers' remittances have a positive and statistically significant impact on the Egyptian bank deposits in the short run but have a statistically insignificant impact on non-governmental foreign currency deposits in the long run. FDI inflows, inflation rate and deposit interest rate have an insignificant impact on the level of Egyptian bank deposits in foreign currency, while trade openness has a positive and statistically significant impact on non-governmental foreign currency deposits, both in the long run and short run. Foreign exchange growth rate has a direct significant impact on non-governmental foreign currency deposits in the long run, but an insignificant impact on the level of Egyptian bank deposits in the short run. This paper recommends that the CBE, Egyptian government, and banks should take actions to increase the volume of remittances through formal banking sector and adjust deposit interest rate on long-term foreign currency deposits.

Replication Factor C Subunit 4 (RFC4), an oncogene implicated in many human cancers, has yet to be extensively studied in many cancer types to determine its expression patterns and tumor tissue function. Various bioinformatics tools were used to analyze RFC4 as a potential oncogene and therapeutic target across many cancers. We first examined RFC4 expression levels in several human tumor types to determine relationships with tumor grade, stage, metastasis, and patient survival. We also examined RFC4’s genetic changes, epigenetic methylation, and effect on tumor microenvironment (TME) immune cell infiltration. We also analyzed RFC4’s connections with immunological checkpoints to identify potential molecular pathways involved in carcinogenesis. Our findings show that RFC4 is upregulated in several tumor types and associated with poor prognoses in many human cancers. This study shows that RFC4 significantly affects the tumor immunological microenvironment, specifically immune cell populations. Finally, we screened for RFC4-inhibiting pharmacological compounds with anti-cancer potential. This study fully elucidates RFC4’s carcinogenic activities, emphasizing its potential as a prognostic biomarker and a target for anti-cancer therapy.

Background and Objectives: Endoscopic biliary plastic stenting is a safe and effective temporary therapeutic modality used in various benign biliary disorders. Long-term indwelling stents for more than one year without retrieval are termed “forgotten biliary stents”. In clinical practice, the forgotten stents are underestimated and the majority of data were obtained from case reports. The aim of this study was to determine the forgotten-biliary-plastic-stent-related complications, their management, and the patients’ clinical outcomes. Materials and Methods: This retrospective study was performed at three hospitals during the period from January 2021 to December 2023. In total, 577 patients with biliary plastic stents—inserted for a variety of benign biliary conditions—were included. They were divided into two groups, as follows: group 1 included 527 patients who had biliary stents removed within 3 months, and group 2 included 50 patients with biliary stents retrieved after one year of their deployment. The stent-related complications (e.g., acute cholangitis, stent clogging, distal stent migration, new common bile duct (CBD) stone formation, and proximal stent migration) and the endoscopic management success rate were evaluated. Results: Irretrievable CBD stones were the main indication for biliary plastic stenting in both groups. The stent-related complications, number of endoscopic sessions, and hospital admissions were significantly higher in the patients with forgotten biliary stents than those with stent removal within 3 months. All the study patients were successfully managed endoscopically with uneventful outcomes. Conclusions: Based on this retrospective study, non-adherence to the endoscopists’ instructions is the main reason for retained biliary stents for more than one year. The patients with forgotten stents had significantly higher complication rates, a higher number of endoscopic sessions, and a higher number of hospital admissions than those with stents that were retrieved in the scheduled time. All patients were managed endoscopically with a technical success rate of 100%, and with no complication-related mortality.

Objective To assess the diagnostic accuracy and agreement of CT and MRI in terms of the Bosniak classification version 2019 (BCv2019). Materials and methods A prospective multi-institutional study enrolled 63 patients with 67 complicated cystic renal masses (CRMs) discovered during ultrasound examination. All patients underwent CT and MRI scans and histopathology. Three radiologists independently assessed CRMs using BCv2019 and assigned Bosniak class to each CRM using CT and MRI. The final analysis included 60 histopathologically confirmed CRMs (41 were malignant and 19 were benign). Results Discordance between CT and MRI findings was noticed in 50% (30/60) CRMs when data were analyzed in terms of the Bosniak classes. Of these, 16 (53.3%) were malignant. Based on consensus reviewing, there was no difference in the sensitivity, specificity, and accuracy of the BCv2019 with MRI and BCv2019 with CT (87.8%; 95% CI = 73.8–95.9% versus 75.6%; 95% CI = 59.7–87.6%; p = 0.09, 84.2%; 95% CI = 60.4–96.6% versus 78.9%; 95% CI = 54.4–93.9%; p = 0.5, and 86.7%; 95% CI = 64.0–86.6% versus 76.7%; 95% CI = 75.4–94.1%; p = 0.1, respectively). The number and thickness of septa and the presence of enhanced nodules accounted for the majority of variations in Bosniak classes between CT and MRI. The inter-reader agreement (IRA) was substantial for determining the Bosniak class in CT and MRI ( k = 0.66; 95% CI = 0.54–0.76, k = 0.62; 95% CI = 0.50–0.73, respectively). The inter-modality agreement of the BCv219 between CT and MRI was moderate ( κ = 0.58). Conclusion In terms of BCv2019, CT and MRI are comparable in the classification of CRMs with no significant difference in diagnostic accuracy and reliability. Key Points • There is no significant difference in the sensitivity, specificity, and accuracy of the BCv2019 with MRI and BCv2019 with CT. • The number of septa and their thickness and the presence of enhanced nodules accounted for the majority of variations in Bosniak classes between CT and MRI. • The inter-reader agreement was substantial for determining the Bosniak class in CT and MRI and the inter-modality agreement of the BCv219 between CT and MRI was moderate.

Background and Aims. The etiological factors involved in the etiology of autism remain elusive and controversial, but both genetic and environmental factors have been implicated. The aim of this study was to assess the levels and possible environmental risk factors and sources of exposure to mercury, lead, and aluminum in children with autism spectrum disorder (ASD) as compared to their matched controls. Methods. One hundred ASD children were studied in comparison to 100 controls. All participants were subjected to clinical evaluation and measurement of mercury, lead, and aluminum through hair analysis which reflects past exposure. Results. The mean Levels of mercury, lead, and aluminum in hair of the autistic patients were significantly higher than controls. Mercury, lead, and aluminum levels were positively correlated with maternal fish consumptions, living nearby gasoline stations, and the usage of aluminum pans, respectively. Conclusion. Levels of mercury, lead, and aluminum in the hair of autistic children are higher than controls. Environmental exposure to these toxic heavy metals, at key times in development, may play a causal role in autism.